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Donald J. Davidson Research Department of Orthopaedics and Musculoskeletal Sciences, University College London, London, UK
Department of Microbial Diseases, UCL Eastman Dental Institute, University College London, London, UK

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David Spratt Department of Microbial Diseases, UCL Eastman Dental Institute, University College London, London, UK

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Alexander D. Liddle Department of Microbial Diseases, UCL Eastman Dental Institute, University College London, London, UK
MSK Lab, Imperial College London, London, UK

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with a less established PJI more amenable to antibiotic therapies. 20 , 21 Biofilms Once bacteria have gained access to the surgical site they can exist in suspension, biofilm or invasive (intracellular) forms. 22 Suspended, single

Article Type:
Review Article
Category:
Hip
DOI:
https://doi.org/10.1302/2058-5241.4.180095
Volume/Issue:
Volume 4: Issue 11
Open access
Petra Izakovicova HELIOS Klinik Zerbst/Anhalt, Germany

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Olivier Borens Service of Orthopaedics and Traumatology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland

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Andrej Trampuz Charité – Universitätsmedizin Berlin, Corporate Member of Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center for Musculoskeletal Surgery (CMSC), Berlin, Germany

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cumulative risk for haematogenous infections during the entire implant lifetime. Development of modern detection methods for microbial biofilms helps to recognize even chronic infections that would previously have been missed. Management of PJI requires

Article Type:
Review Article
Category:
General Orthopaedics
DOI:
https://doi.org/10.1302/2058-5241.4.180092
Volume/Issue:
Volume 4: Issue 7
Open access
Razvan Ene Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania
Bucharest Emergency Clinical Hospital, Romania

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Mihai Nica Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania
University Emergency Hospital Bucharest, Romania

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Dragos Ene Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania
Bucharest Emergency Clinical Hospital, Romania

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Adrian Cursaru Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania
University Emergency Hospital Bucharest, Romania

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Catalin Cirstoiu Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania
University Emergency Hospital Bucharest, Romania

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the surface’ concept, states that bacteria and host tissue compete for the surface of the implants. If bacterial adherence and colonization ensues first, then the eradication of infection becomes difficult. 6 This is due to biofilm which is a

Article Type:
Review Article
Category:
General Orthopaedics
DOI:
https://doi.org/10.1302/2058-5241.6.200083
Volume/Issue:
Volume 6: Issue 5
Open access
Heinz Winkler Osteitis Centre, Privatklinik Döbling Wien, Heiligenstaedter Strasse 57-63, A-1190 Wien, Austria

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able to bind to damaged tissue and implanted material with immediate formation of biofilms that may be considered mature after several days. Clinical signs persisting for longer than ten days are associated with the development of necrotic bone and

Article Type:
Research Article
Category:
General Orthopaedics
DOI:
https://doi.org/10.1302/2058-5241.2.160063
Volume/Issue:
Volume 2: Issue 5
Open access
T. Fintan Moriarty AO Research Institute Davos, Switzerland

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Richard Kuehl University Hospital of Basel, Switzerland

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Tom Coenye Ghent University, Belgium

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Willem-Jan Metsemakers University Hospitals Leuven, Belgium

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Mario Morgenstern Trauma Centre, Murnau, Germany

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Edward M. Schwarz University of Rochester Medical Center, New York, USA

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Martijn Riool AMC, University of Amsterdam, The Netherlands

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Sebastian A.J. Zaat AMC, University of Amsterdam, The Netherlands

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Nina Khana University Hospital of Basel, Switzerland

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Stephen L. Kates Virginia Commonwealth University, Virginia, USA

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R. Geoff Richards AO Research Institute Davos, Switzerland

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be challenging. 22 With reference to ODRI, bacteria resistant to the few antibiotics with proven anti-biofilm activity (Rifampicin-resistant staphylococci and ciprofloxacin-resistant Gram-negatives) are among the most difficult pathogens to treat

Article Type:
Research Article
Category:
General Orthopaedics
DOI:
https://doi.org/10.1302/2058-5241.1.000037
Volume/Issue:
Volume 1: Issue 4
Open access
Sylvain Steinmetz Service of Orthopaedics and Traumatology, Lausanne University Hospital, Lausanne, Switzerland

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Diane Wernly Service of Orthopaedics and Traumatology, Lausanne University Hospital, Lausanne, Switzerland

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Kevin Moerenhout Service of Orthopaedics and Traumatology, Lausanne University Hospital, Lausanne, Switzerland

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Andrej Trampuz Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery (CMSC), Berlin, Germany

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Olivier Borens Service of Orthopaedics and Traumatology, Lausanne University Hospital, Lausanne, Switzerland

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may already have formed a biofilm, although this biofilm may still be in an ‘immature’ phase. Highly virulent organisms, like Staphylococcus aureus or gram-negative bacilli, are frequent causative agents of early infection. 4 Delayed

Article Type:
Review Article
Category:
General Orthopaedics
DOI:
https://doi.org/10.1302/2058-5241.4.180093
Volume/Issue:
Volume 4: Issue 7
Open access
Tristan Ferry Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
Université Claude Bernard Lyon 1, Villeurbanne, France
Centre de Références des IOA Complexes de Lyon, CRIOAc Lyon, Lyon, France
StaPath team, Centre International de Recherche en Infectiologie, CIRI, Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
Education and Clinical Officer of the ESCMID Study Group for Non-traditional Antibacterial Therapy (ESGNTA)

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Jolien Onsea Department of Trauma Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
Department of Development and Regeneration, KU Leuven, Oude Markt 13, Leuven, Belgium

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Tiphaine Roussel-Gaillard Institut des Agents Infectieux, Centre de Biologie et de Pathologie du Nord, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France

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Cécile Batailler Service de Chirurgie Orthopédique et de Médecine du Sport, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France

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Thomas Fintan Moriarty AO Research Institute Davos, Clavadelerstrasse 8, Davos Platz, Switzerland

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Willem-Jan Metsemakers Department of Trauma Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
Department of Development and Regeneration, KU Leuven, Oude Markt 13, Leuven, Belgium

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, limited mobility, and a higher mortality rate compared to patients who do not develop this complication ( 3 , 6 ). Management concepts consist of a combined surgical and antibiotic treatment approach. Because these infections are biofilm

Article Type:
Review Article
Category:
General Orthopaedics
DOI:
https://doi.org/10.1530/EOR-24-0042
Volume/Issue:
Volume 9: Issue 5
Open access
Christof Berberich Department of Medical Training and Education, Heraeus Medical GmbH, Wehrheim, Germany

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Pablo Sanz-Ruiz Department of Traumatology and Orthopaedic Surgery, General University Hospital Gregorio Marañón, Madrid, Spain

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deep infections due to bacterial colonization and biofilm formation on implant surfaces. Among the strategies taken to prevent these feared infections, peri-operative antibiotic prophylaxis (PAP) is widely accepted as a potent anti-infective measure in

Article Type:
Review Article
Category:
General Orthopaedics
DOI:
https://doi.org/10.1302/2058-5241.4.180104
Volume/Issue:
Volume 4: Issue 10
Open access
Ismail Remzi Tözün Department of Orthopaedic Surgery and Traumatology, Acibadem Mehmet Ali Aydınlar University, School of Medicine, Acibadem Maslak Hospital, Sarıyer/Istanbul, Turkey

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Vahit Emre Ozden Department of Orthopaedic Surgery and Traumatology, Acibadem Mehmet Ali Aydınlar University, School of Medicine, Acibadem Maslak Hospital, Sarıyer/Istanbul, Turkey

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Goksel Dikmen Department of Orthopaedic Surgery and Traumatology, Acibadem Mehmet Ali Aydınlar University, School of Medicine, Acibadem Maslak Hospital, Sarıyer/Istanbul, Turkey

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Kayahan Karaytuğ Department of Orthopaedic Surgery and Traumatology, Acibadem Mehmet Ali Aydınlar University, School of Medicine, Acibadem Maslak Hospital, Sarıyer/Istanbul, Turkey

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development of symptoms. Late PJI is defined as PJI that develops after 12 months following the index surgery. The primary time distinction between early and late PJI is based on the assumed time of biofilm formation on the surface of the components, generally

Article Type:
Review Article
Category:
Knee
DOI:
https://doi.org/10.1302/2058-5241.5.190069
Volume/Issue:
Volume 5: Issue 10
Open access
Hagen Schmal Department of Orthopaedics and Traumatology, Odense University Hospital, Odense, Denmark.
Department of Orthopaedics and Traumatology, Freiburg University Hospital, Freiburg, Germany.

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Michael Brix Department of Orthopaedics and Traumatology, Odense University Hospital, Odense, Denmark.

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Mats Bue Department of Orthopaedic Surgery, Horsens Regional Hospital, Horsens, Denmark

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Anna Ekman Orthopaedic Department, Södersjukhuset, Stockholm, Sweden

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Nando Ferreira Division of Orthopaedics, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa

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Hans Gottlieb Department of Orthopaedic Surgery, Herlev Hospital, Herlev, Denmark

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Søren Kold Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg University, Aalborg, Denmark

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Andrew Taylor Department of Orthopaedic Surgery, Nottingham University Hospitals, UK

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Peter Toft Tengberg Department of Orthopaedic Surgery, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark

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Ilija Ban Department of Orthopaedic Surgery, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark

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Danish Orthopaedic Trauma Society Department of Orthopaedic Surgery, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark

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to this phenomenon such as biofilm formation, 61 survival of bacteria in inactive forms, and internalization of bacteria. 62 This allows the infection to persist and to become reactivated in times of a suppressed immune system. Radiographic

Article Type:
Research Article
Category:
Trauma
DOI:
https://doi.org/10.1302/2058-5241.5.190037
Volume/Issue:
Volume 5: Issue 1
Open access